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Week ahead: Senate checks up on exchanges
The Hill
It's a big week, between the State of the Union address and a raft of health policy events. The week will see a Capitol Hill fly-in by medical students affiliated with the American Medical Association. The group will lobby members and staff on support for graduate medical education and student debt relief. Additionally, the Alliance for Health Reform will hold a briefing on Medicare policy in the Dirksen Senate Office Building.
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'Keeping You Healthy' video: Telemedicine Program by
WellPoint / Anthem Blue Cross

MHPA
VideoBrief
WellPoint State Sponsored Business is the only private health plan to develop, manage and comprehensively support a statewide Telemedicine program to improve access to care in California. Telemedicine can be used by local primary care providers to obtain second opinions on difficult cases to avoid misdiagnosis and prescribing ineffective medications. It can also significantly reduce disparities and accessibility barriers. Timely access to specialty care means early identification and treatment of conditions, resulting in better health outcomes and lower health costs. Join Michael Martineau from Anthem Blue Cross and Michelle Martin from MHPA's Center for Best Practices as they discuss this innovative program.

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New compendium on diabetes care from MHPA's Center for Best Practices
MHPA
Prevention of diabetes is a key area of emphasis for health plans. Medicaid health plans have a variety of diabetes prevention programs and collaborations to promote physical activity, encourage healthy eating and help people maintain a healthy weight. Health plan prevention approaches are multifaceted and include community-based strategies, programs to support clinicians in improving care and programs to educate patients. These interventions are critical to stem the rising tide of diabetes. This publication offers information on best practices in diabetes care from MHPA health plans and partner organizations. Geared primarily towards Medicaid health plans, state leaders and other policymakers, it also lists resources with website links that can help readers find information about preventing and managing diabetes.
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DST Health Solutions' CareAnalyzer achieves
NCQA HEDIS certification for 12th consecutive year

PR Newswire via KGO-TV
DST Health Solutions, LLC, announced that it has earned National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set Software Certification for its CareAnalyzer HEDIS product, as it has done successfully since 2002. This product calculates the comprehensive set of performance measures to support annual audit and reporting requirements that all United States health plans seeking NCQA accreditation must meet.
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Advocates say GOP proposal would ration Medicaid for kids
The Hill
A Republican proposal to reform Medicaid would ration care for one-third of U.S. kids, advocates said. First Focus, a bipartisan group, responded to the idea of per-capita Medicaid caps floated by Senate Finance Ranking Member Orrin Hatch of Utah and Rep. Bill Cassidy of Louisiana. Hatch endorsed the policy in January as a way to reduce the deficit. Per-capita caps would limit Medicaid spending based on a beneficiary's health condition and eligibility category — child, senior, disabled person and so on.
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Medicaid transformation watched closely in Florida
Kaiser Health News
The federal government has signed off on the first part of a plan that could eventually steer more than 3 million low-income Floridians on Medicaid into a managed care or HMO system. The decision comes two years after Florida lawmakers approved the conversion in an attempt to control costs in the $21 billion program. At that time, retirees were skeptical of how it would work.
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Four health plans selected for New Mexico's Medicaid expansion
Albuquerque Business First
The New Mexico Human Services Department announced that four health plans have been chosen to provide insurance to 700,000 New Mexicans who receive healthcare services through the state's Medicaid program. The four providers are Blue Cross and Blue Shield of New Mexico, Molina Healthcare of New Mexico, Presbyterian Health Plan and UnitedHealthcare Community Plan of New Mexico, HSD said in a news release.
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HealthCare Partners seeks California state license to
operate as managed-care plan

Los Angeles Times
HealthCare Partners, the medical-group giant acquired last year by dialysis chain DaVita Inc. for $4.4 billion, is seeking a state license to operate as a managed-care plan after questions were raised about its compliance with California law. The California Department of Managed Health Care has been looking into the nation's largest operator of physician groups since last fall, when a patient sued the Torrance, Calif., company and accused it of acting like a health plan without the necessary Knox-Keene Act license. A spokeswoman for the managed-care agency said the allegations against HealthCare Partners "are still under review."
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Feds reject Mississippi proposal to create
state-run health insurance exchange

The Associated Press via The Washington Post
Mississippi Insurance Commissioner Mike Chaney says federal officials have rejected the state's proposed health insurance exchange. Under the federal health law that President Barack Obama signed in 2010, every state is required to have an exchange so people can get coverage starting in January 2014, much of it federally subsidized. States that don't create their own will have one run by Washington.
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In Virginia Health Secretary Bill Hazel, lawmakers find an
honest broker in Medicaid expansion struggle

The Associated Press via The Washington Post
Not too many years ago, Bill Hazel was repairing the broken bones and torn joints of clientele as diverse as the poor in Bolivia and the well-paid bruisers of the Washington Redskins. But the healing he accomplished in the Richmond, Va., legislative corridors may rival anything he's done with a scalpel.
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California lacks doctors to meet demand of national healthcare law
Los Angeles Times
As the state of California moves to expand healthcare coverage to millions of Californians under President Barack Obama's healthcare law, it faces a major obstacle: There aren't enough doctors to treat a crush of newly insured patients. Some lawmakers want to fill the gap by redefining who can provide healthcare.
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New York hopes to add 500,000 residents to Medicaid
The Associated Press via The Saratogian
With New York's Medicaid coverage already broader than federal law requires, the state expects to add about 75,000 more people to the program next year under the healthcare overhaul, plus another 425,000 who are already eligible but don't know it. Medicaid currently covers 5.1 million New Yorkers, more than one-fourth of the state's residents.
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Florida enhances program for disabled children
The Associated Press via San Francisco Chronicle
Florida health officials said they will assign care coordinators to about 1,600 children with disabilities amid allegations from federal health officials that the state was cutting in-home services and essentially forcing children into adult nursing homes. An individual care coordinator will work with no more than 40 disabled children at a time who are receiving in-home nursing services and ensure they have continued access to those services.
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Recent webinar presentations from PwC, Deloitte, AmeriHealth Mercy available free on MHPA's website
MHPA
View PDFs of "The Race to 2014: Health Reform and the 30 Million Newly Insured" by PwC, "The Fiscal Cliff, ACA, and Medicaid Managed Care" by Deloitte Consulting, "Optimizing Pharmaceutical Care in a Drug Therapy Management Program" by The AmeriHealth Mercy Family of Companies, and more.
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MHPA's Amy Ingham to speak at 6th Annual Leadership Summit on Medicaid Managed Care | Feb 25-27 | Arlington, Va.
World Congress via MHPA
Payment transformation continues in Medicaid, as well as the development of integrated care delivery models industrywide. Medicaid managed care plans must continue to show their value. Attend the 6th Annual Leadership Summit on Medicaid Managed Care to learn how. MHPA members, receive a $200 discount when you register online or at 1-800-767-9499 with promo code MHPA200. Discounts are not valid on government rates.
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Annual Medicaid Managed Care Congress | May 20-22 | Baltimore Marriott Inner Harbor Hotel | Baltimore
Institute for International Research
Collaborate and drive innovation to move the Medicaid industry forward. Implement the ACA, increase quality, grow membership and strengthen financials. Register with code XP1826MHPA, and save 25 percent.
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MHPA on Twitter, LinkedIn and Facebook
MHPA
Follow us on Twitter, LinkedIn and Facebook to get industry-related news and the latest MHPA announcements.
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